Emergency Room Visit

I recently
had a medical emergency that required me to go to the emergency room. From that
visit many things highlighted to me the recent conversation about affordable and
quality health care. As someone with comprehensive medical coverage and living
with HIV I never had to give a thought to the services I received. Although I
was aware of the issue of uninsured people, in the best way I knew how, I could
only relate through their telling. My experience was an eye opening experience
that showed the many levels of inequalities of healthcare. But it also gave me
a perspective as a man with HIV, visiting the local ER. As a disclaimer I
acknowledge all emergency rooms are a waiting room and none claim to offer Four
Seasons type service but I do feel there is a difference in how private and
city run emergency rooms operate.

My episode
began when I sat down for dinner. I knew the moment I swallowed the steak that
I was in trouble as it quickly became lodged in my esophagus. This had happened
many times before with others warnings me to take small bites. Previous
incidents didn't result in any drastic action so when it happened I felt it
would resolve itself. Yet this felt different as no matter what I attempted it
just wasn't going down. Despite the efforts of doing a self-Heimlich, drinking
a diet Coke which usually helps and according to Google, consuming a table
spoon of white vinegar, it simply was not dislodging. So the night was spent
with the inability to drink water and swallow food. You would think I would
have immediately went to the hospital but knowing how emergency rooms operate
and it being late I simply didn't want to spend a night in a room waiting to be
seen. Besides I was sure that during my sleep it would go down by itself.

Having gone 12
hours without food and water I couldn't even take my HIV medication as it would
come right back up. I was out of it and in no mood to take the two subway
trains to a reputable emergency room located 45 minutes from the house. I was
also feeling cheap and didn't want to spend money on a cab. I just wanted a
quick fix and chose to take myself to the city run hospital that was only 15
minutes away. This hospital is known for bandaging the shooting victims of the
inner city and pushing them out to be shot again. Based on it's location it's
the only medical facility for nearby residents and those without health
insurance. It's because of its close proximity I made my way to it.

While
waiting my turn I overheard one man looking for a refill on his Prezista prescription,
a HIV medication. My ears pricked up as I wondered to myself what makes that an
emergency. Soon after, two guys who were showing each other a lot of public
display of affection exclaimed loudly they were there to get some 'crazy pills'.
I assumed that it was a derogatory slang for mental health medications which is
no joking matter. In fact I was surprised on how opened many were about their
reason for coming in. In their public share it was evident that most of their
conditions could have been covered with a regular clinic visit but that's hard
to do if you don't have insurance. Yet without insurance this may have been
their only option. A quick adding of the numbers saw that for those who opposed
affordable health care, tax payers are paying double to send someone to the
emergency room than they would have sending a person to a regular doctor visit.

My interesting
interaction moment came during the intake process. As I was explaining to the
nurse why I was there, she asked about any other medical conditions. When I
informed her I was HIV positive she immediately grabbed her pen and wrote down
a name of a doctor. She informed me to go to YouTube and watch this doctor's
videos as he had a cure for HIV. I was shocked that here she was pushing a voodoo
doctor on me while I'm trying to see a real doctor. What was also disturbing
was the irresponsibility of this medical representative and basically someone
who should have known better, passing along misinformation of a disease that is
already misunderstood by others. And the scary realization was knowing it was
highly unlikely that I was the first she shared this information with and the
realization there may have been follow- through on others with this information.
It left me wondering how many others have delayed their care with hopes to
getting a quick cure for their HIV.I was too weak to challenge the information
she provided at that time and reminded myself to call the hospital when I was
feeling better.

Despite the
interaction with her it was assuring to hear the hospital offering people waiting,
the opportunities to receive a HIV test. The discouragement came when two
people hearing the word laughed and loudly state, "Nobody wants to hear
about the 'Monster' a term I hadn't heard for a while but reaffirmed the stigma
HIV had attached to it. With all these HIV reference in one sitting I thought
someone must have known I blogged about HIV and I was getting punked.

Thankfully I
made it past the waiting room and moved to the next room of purgatory as my
waiting continued. I would get excited when I would see nurses come in but be
deflated as they were in there to grab medical supplies. I laughed as I
realized that I was placed in a medical closet. My self-advocacy skills were
not effective as each nurse were tone deaf to my asking when I would be seen. I
did see one nurse and after asking about my HIV status he ignored the fact I
was dehydrated but found the time to give me HIV 101 lessons. In my delirium I
wanted to say I've had HIV longer than your medical profession but knew I was
at their mercy.

In my
delirium I had texted Joel who rushed down there. When he got there he had this
shell-shocked look. I thought it was about my situation but it was more about
passing the detectives who were standing outside the room of a guy who was
shot. It was nice to have him help cure the loneliness but him being there had
another unexpected benefit. Whereas my previous requests for service were
unheeded, Joel simply made one request and like that the flood gates of comfort
came rushing in. I have to add that Joel is white and I strongly believe that
his race changed my level of service. In an instance the missing nurses and
doctors suddenly came flooding, stumbling over each other with one of the
attending nurses giving me movie star treatment. Instantly I was given a nice
fluffy pillow along with a comfortable blanket and the side railings of my bed
were raised to make a comfortable bed. I even was even bought Ginger Ale which
didn't help me as I couldn't drink it but nonetheless it came with a package of
services that was once denied.

Even Joel noticed the attentiveness
and it was shocking to see the inequality. But sadly I think it's the reality
for many. Living with HIV and no health insurance is a scary thought. The good
news was despite no coverage people were seeking care but receiving it in a
piecemeal fashion. There are health programs like ADAP but even those programs
are getting stretched with long waiting lists or hung up in current budget
debates. It was sad knowing based on this small card in my wallet I had access
to a regular physician, specialist and dare I say a less chaotic medical
setting. The issue of health care is real and each day many including my brethren
living with HIV are on the unbalanced side of accessible care. The emergency
room was just a small sliver of that disparity. We may not want to vocalize it
but there is a huge difference when you have health insurance.

They ended up not fixing the problem and I had
to go to my private hospital and the service was like night and day. I was seen
in a timely fashion, received an IV for my inability to drink water and a team
of doctors removed the piece of steak. I was able to get that type of service
because I had health insurance. My little episode showed how important it is to
lend my voice to the fight for affordable and quality health care for all. And
for that nurse who referred me to YouTube, in case you are reading this, I reported
you so hopefully you will be talked to and sadly it may be business as usual.

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2 Comments

Comments on Aundaray Guess's blog entry "Emergency Room Visit"

I have had the privilege of living in Thailand for a period of time and needed services several times. I immediately informed them of my HIV status and it made no difference to any of the Doctors or nurses, in fact they were very attentive of my needs. I was almost always seen immediately and treated without waiting more than a few minutes. They had a lot of patients and the hospital was more updated with equipment than I have seen in USA. Why is that? We sould look at why we can handle the capsity of patients that other countries seem to handle. Each time I made a visit, I left with complete satisfaction they had addressed my problem and admistered the proper treatment, brought me to the in hospital pharmacy where my prescriptions were waiting for me and the cashier where I paid the bill. The BILL was extremely cheap and yet I received medications that were so expensive in USA. The ER was very inexpensive, usually total bill with medications was under 100 bucks, less than my insurance co-pay for the same treatment. Plus the ease of going in and coming out in a fraction of the time. I waited the longest to pay my bill since there was about 200 people waiting for prescrips and bills. Very busy hospital but totally organized, wish it would happen in USA but our medical staff are so concerned about catching HIV they don't do there jobs properly. I know I have been discriminated in USA many times because I am HIV pos, so I will not go to a hospital unless I am in capacitated. I had a kidney stone recently, which I have had before and just waited out the severe pain then to go to the hospital.

thank you for sharing your story, yes I have being treated so bad also in the A & E,
Now I will only go their if I am half dead, I live in new zealand and if you have HIv/Aids you still cannot get medical insurance.